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Central Venous Catheters

Topic Overview

What is a central venous catheter?

A central venous catheter, also called a central line, is a
long, thin, flexible tube used to give medicines, fluids, nutrients, or blood
products over a long period of time, usually several weeks or more. A catheter
is often inserted in the arm or chest through the skin into a large vein. The
catheter is threaded through this vein until it reaches a large vein near the
heart.

A catheter may be inserted into the neck if it will be used only
during a hospital stay.

What is a central venous catheter used for?

Central venous catheters are used to:

Give long-term medicine treatment for pain,
infection, or cancer, or to supply nutrition. A central venous catheter can be
left in place far longer than an
intravenous catheter (IV), which gives medicines into
a vein near the skin surface.

Give medicines that affect the heart,
especially if a quick response to the medicine is wanted.

Give large amounts of blood or fluid quickly.

Take frequent blood samples without having to "stick" someone with a needle.

Receive kidney dialysis if you have kidney failure.

A central venous catheter can be
left in place far longer than an
intravenous catheter (IV), which gives medicines into
a vein near the skin surface. Also, a central venous catheter allows a person to receive IV medicines at home.

What types of central venous catheters are there?

There are several types of central venous catheters.

PICC line. A peripherally inserted central
catheter, or PICC line (say "pick"), is a central venous catheter inserted into
a vein in the arm rather than a vein in the neck or chest.

Tunneled
catheter. This type of catheter is surgically inserted into a vein in the neck
or chest and passed under the skin. One end of the catheter remains outside the skin. Medicines can be given through an opening in this end of the catheter. Passing the catheter
under the skin helps keep it in place better, lets you move around easier, and
makes it less visible.

Implanted port. This type is similar to a
tunneled catheter but is left entirely under the skin. Medicines are injected
through the skin into the catheter. Some implanted ports contain a small
reservoir that can be refilled in the same way. After being filled, the
reservoir slowly releases the medicine into the bloodstream. An implanted port
is less obvious than a tunneled catheter and requires very little daily care.
It has less impact on a person's activities than a PICC line or a tunneled
catheter.

Can complications result from the use of a central venous catheter?

Possible complications from the use of a central venous catheter
include:

Bleeding, caused by inserting the catheter
into the vein. But this is usually mild and will stop by itself.

Infection, requiring treatment with antibiotics or removal
of the catheter.

Blood clots, which can form in blood vessels, especially in the arms.

A blocked line. This can happen from a blood clot or from something else getting stuck in the line. Regular flushing of the catheter can help keep the line clear. Preventing infections and making sure the catheter is in place can also help keep the line clear.

Kinking of the catheter. A twisted or kinked catheter must be
repositioned or replaced.

Pain. You may experience pain at the
place where the catheter is inserted or where it lies under your
skin.

Collapsed lung (pneumothorax).
The risk of a collapsed lung varies with the skill of the person inserting the
catheter and the site of placement. It is most likely to happen during
placement of a catheter in the chest, although the risk is small.

Shifting of the catheter. A catheter that has moved out of
place can sometimes be repositioned. If repositioning does not work, it must be
replaced.

Try to keep the exit site dry. This can help prevent infection. When you shower, cover the site with waterproof material, such as plastic wrap. Be sure you cover both the exit site and the central line cap(s).

Fasten or tape the central line to your body to prevent it from pulling or dangling.
Avoid bending or crimping your central line. And wear clothing that doesn't rub or pull on your central line.

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